It is important to realise that even the use of a condom by a man with genital warts or HPV infection may not protect his partner from transmission...

Question

I received laser surgery to my vocal cords from a specialist ears, nose and throat (ENT) surgeon who told me I had papillomas on my vocal cords.

I was so busy asking him about the long-term implications and the effects on my career as a salesperson, that I forgot to ask how I got them.

When I was told I had polyps, I thought this was down to my ex-smoking habit and straining my voice.

Now I realise it is papillomas and that it is a wart virus, I wonder what the cause is. Could it be the genital wart virus contracted through oral sex?

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If so, how long before the hoarse voice becomes apparent would oral sex have to take place? Am I contagious to kiss and to give oral sex now?

Please fill me in because if this is the case I am ashamed to tell people about my condition and I feel really dirty.

I can't get this out of my mind and it is getting me down.

Answer

I am sorry to learn of your condition and can understand your concern and the confusion that has arisen as a result of the diagnosis.

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A papilloma may develop in the larynx and is defined as a benign wart-like growth occurring as a result of infection with a virus.

Even assuming your infection did occur as a result of oral sex, I am unable to say how long before your hoarse voice became apparent this is likely to have taken place, or whether you are contagious to kiss and to give oral sex now.

I will attempt to demystify the subject for you by discussing human papilloma virus (HPV) infection in some detail.

Unfortunately, we do not have a lot of information about the transmission of HPV and for how long it infects people.

Latterly it has been discovered that the development of cervical cancer is strongly associated with genital infection of HPV with around 95 per cent of patients developing cervical cancer having evidence of infection.

However, the majority of women infected with HPV never develop cancer. Therefore, additional factors are necessary and smoking appears to be the most significant environmental risk factor – another good reason not to smoke.

More recently, there have been studies following normal female college students, who did not have genital warts or cancer, to see how often they were infected with HPV.

In one such study, on the first examination, 11.2 per cent of the women had antibodies to one strain of HPV, meaning that they had had the infection at some time, but only 6.9 per cent had the virus in their vaginas.

Therefore it would appear that about half of these infected women had got over the infection at this stage.

Four years later, 80 per cent of the sexually active women had been infected with HPV and 9 out of 10 had no warts or abnormalities on their cervical smear test.

Although the great majority of infections came from sexual relations, a minority was thought to be due to contact with inanimate objects, ie through non-sexual means.

The rate of transmission through oral sex was extremely small if it occurred at all.

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About 0.17 per cent of women who had had oral sex had virus in their mouths, and about 0.12 per cent of women who denied ever having had oral sex also had virus in their mouth. That's only about 1 in a 1000.

Therefore, in summary, HPV infection is extremely common.

It is important to realise that even the use of a condom by a man with genital warts or HPV infection may not protect his partner from transmission of the virus if they come into contact with infected areas that are not covered by the condom.

The infection may eventually go away, most infected people never get a wart, and transmission through oral sex is rare.

The vast majority of HPV infections never lead to any serious disease and it is likely that genetic factors will prove important in determining one's individual disease risk in this regard.

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.

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